England’s NHS is heading into winter with growing pressure across emergency and planned care, as the hospital waiting list rises for a third consecutive month and ambulance response times worsen.
Figures published by NHS England on 12 November show that an estimated 7.38 million treatments were waiting to be carried out at the end of September, up slightly from 7.37 million in August. The backlog relates to around 6.24 million patients and is at its highest level since October 2025.
The increase comes despite some improvement in performance against the 18-week treatment standard. In September, 65.8 per cent of patients began treatment within 18 weeks of referral, compared with 65.2 per cent in August. This was above the 65 per cent target set for March 2026, although the next milestone is to reach 70 per cent by March 2027.
However, longer waits remain a concern. The number of people waiting more than a year for routine treatment increased from 113,339 in August to 116,353 in September. Those waiting more than 65 weeks also rose, from 10,782 to 12,825.
The figures suggest that improvements in some waiting-time measures are yet to translate into a sustained reduction in the overall backlog. The NHS is continuing to receive high volumes of referrals while trying to increase the number of patients treated.
Why is emergency care under pressure?
The latest figures also show that demand for urgent and emergency services has reached record levels.
A&E departments in England recorded 2.5 million attendances in October, the first time monthly visits have exceeded that threshold. Yet only 74 per cent of patients were admitted, transferred or discharged within four hours, down from 74.4 per cent in September. The Government and NHS England have set a target of 78 per cent for March 2026, followed by a target of 82 per cent for every NHS trust by March 2027.
Ambulance response times also deteriorated for several categories of call. For Category 2 incidents, which include suspected heart attacks, strokes and sepsis, the average response time increased to 32 minutes and 45 seconds in October, from 31 minutes and 18 seconds in September. The 2026/27 target is an average of 25 minutes.
The average response to the most serious Category 1 incidents remained at seven minutes and 59 seconds, unchanged from September and above the seven-minute standard. For Category 3 urgent calls, the average response time rose to two hours, seven minutes and 32 seconds, compared with one hour, 57 minutes and 44 seconds a month earlier.
Pressure is also visible inside hospitals. An average of 3,558 patients a day received corridor care in October, including 2,718 in A&E departments and 840 in other hospital areas. This was the highest daily average since the NHS began publishing the measure in May 2026. The figures cover patients who spent at least 45 minutes receiving care in a setting that was not considered clinically appropriate.
The increase in demand follows an already busy September, when A&Es recorded 2.44 million attendances and ambulance services handled 806,707 incidents. Adult acute hospital bed occupancy averaged 94.9 per cent that month, while more than 13,600 patients a day were occupying beds despite being medically fit for discharge.
What will help the NHS manage winter demand?
The latest performance figures come as the health service prepares for the seasonal rise in demand associated with colder weather and respiratory infections. Higher emergency admissions can make it harder for hospitals to free beds, while delayed discharges can restrict capacity for patients arriving through A&E.
The Government has announced an additional £190 million for the NHS in England in 2026-27 to help manage winter pressures, alongside further support for GP services. However, the latest figures underline the scale of the challenge facing hospitals as demand continues to grow.
There is also a longer-term capacity issue. Reducing waiting lists will require hospitals to carry out more planned procedures while maintaining sufficient beds, staff and diagnostic capacity for urgent cases. Better access to community health services and social care can also help prevent avoidable admissions and support patients who are ready to leave hospital.
Community pharmacies are another part of the wider response. They provide accessible advice and treatment for a range of common conditions, as well as vaccination services, potentially helping patients receive care outside hospital where appropriate. Pharmacy Business has previously reported on calls for the Government to recognise the sector’s role in easing winter pressures.
The NHS has made progress against some planned-care targets, but the combination of a rising waiting list, record A&E attendances and longer ambulance response times leaves little room for complacency. The coming months will test whether additional winter support can help services manage immediate demand while longer-term investment addresses the pressures affecting hospitals throughout the year.
